Abstract
Objective: ST-segment elevation myocardial infarction (STEMI) at
younger age though infrequent but very crucial entity, but there is dearth of
available data, however, a rising trend has noticed recently in Asian
countries. The aim was to see the territorial and clinical profile influence on
overall outcomes of young individuals (≤35 years) with STEMI.
Methodology: Patients with STEMI having age of ≤35 years during
August 2020 to December 2020 were recruited and divided into left
anterior descending artery (LAD)-culprit and non-LAD-culprit STEMI
groups in this prospective observational study. Territorial angiographic and
clinical characteristics were compared.
Results: 1435 STEMI patients underwent coronary angiogram, 5.3% (94)
were ≤35 years of age. LAD was culprit in 74.4% of STEMI mainly as a
single vessel disease (SVD) involving the proximal segment as major
territorial angiographic finding while 25.5% were non-LAD-culprit STEMI.
Obesity, smoking, smokeless tobacco use especially gutka, were frequent
in LAD-culprit group. In-hospital and at 3 months mortality was 2.1% (2)
and 7.1% (5) respectively, all related to LAD territory. Rate of safe
discharges and back to routine was 97.2% vs.100% and 70% vs.79.1%
(72), respectively were comparable in both groups.
Conclusion: LAD predominantly its proximal segment is the commonest
culprit territory in patients with STEMI in youth with significant association
to obesity, smoking and smokeless tobacco use especially gutka. LADculprit STEMI is the major territorial determinant for mortality and heart
failure, however, overall clinical outcomes were reasonably good and
comparable with non-LAD-culprit STEMI considering alive discharges and
back to routine life.
Kamran Ahmed Khan, Mahesh Kumar Batra, Dileep Kumar, Sajjad Ali, Vinesh Kumar, Rajesh Kumar, Danish Qayyum, Tahir Saghir, Abdul Samad Achakzai, Jawaid Akbar Sial, Musa Karim. (2021) Territorial Impact On Clinical Outcomes In Young Population With St-segment Elevation Myocardial Infarction, Pakistan Heart Journal, Volume-54, Issue-1.
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